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United States Patent |
5,560,530
|
Bolanos
,   et al.
|
October 1, 1996
|
Graduated anvil for surgical stapling instruments
Abstract
An anvil is disclosed for utilization in conjunction with a surgical
stapling instrument configured to apply rows of staples to body tissue.
The anvil is provided with graduations to delineate the boundaries of the
staple forming area defined thereby, as well as to delineate the range
through which a fastener driving assembly and optional knife blade
translate during a stapling operation.
Inventors:
|
Bolanos; Henry (East Norwalk, CT);
Lehn; Randolph F. (Stratford, CT)
|
Assignee:
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United States Surgical Corporation (Norwalk, CT)
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Appl. No.:
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533534 |
Filed:
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September 25, 1995 |
Current U.S. Class: |
227/176.1; 227/19; 227/180.1 |
Intern'l Class: |
A61B 017/068 |
Field of Search: |
227/19,180.1,175.1,176.1
|
References Cited
U.S. Patent Documents
D272851 | Feb., 1984 | Green et al.
| |
D278080 | Mar., 1985 | Green et al.
| |
D284698 | Jul., 1986 | Green.
| |
3079606 | Mar., 1963 | Bobrov et al.
| |
3317105 | May., 1967 | Astafjev et al. | 227/19.
|
3490675 | Jan., 1970 | Green et al.
| |
3499591 | Mar., 1970 | Green.
| |
4290542 | Sep., 1981 | Fedotov et al. | 227/19.
|
4491133 | Jan., 1985 | Menges et al. | 227/19.
|
4633874 | Jan., 1987 | Chow et al.
| |
4784137 | Nov., 1988 | Kulik et al. | 227/180.
|
5040715 | Aug., 1991 | Green et al.
| |
5083695 | Jan., 1992 | Foslien et al. | 227/19.
|
5263629 | Nov., 1993 | Trumbull et al. | 227/19.
|
Foreign Patent Documents |
0179623 | Apr., 1986 | EP.
| |
0491537 | Jun., 1992 | EP.
| |
Other References
Information Booklet for Auto Suture.RTM. Multifire Endo GIA.TM. 30
Disposable Surgical Stapler (Apr., 1991, Auto Suture Co., a division of
United States Surgical Corporation).
|
Primary Examiner: Smith; Scott A.
Parent Case Text
This is a continuation of application Ser. No. 08/224,361, filed on Apr. 7,
1994, now abandoned.
Claims
What is claimed is:
1. In a surgical apparatus configured to apply at least two parallel rows
of staples to body tissue, the apparatus including a cartridge housing a
plurality of staples, an anvil mounted adjacent the cartridge against
which the staples are driven when ejected from the cartridge, and a staple
driving assembly which translates through the cartridge to eject the
staples therefrom, the improvement comprising:
at least two visible spaced apart graduations provided on each of the anvil
and the cartridge to delineate a range through which the staple driving
assembly translates to eject staples from the cartridge.
2. A surgical apparatus as recited in claim 1, wherein the anvil defines a
longitudinal axis and the at least two spaced apart graduations define
linear markings extending transverse to the longitudinal axis of the
anvil.
3. A surgical apparatus as recited in claim 1, wherein the spaced apart
graduations are etched into the anvil.
4. A surgical apparatus as recited in claim 1, wherein the spaced apart
graduations are imprinted on of the anvil.
5. A surgical apparatus as recited in claim 1, wherein the anvil is
detachably mounted adjacent the cartridge.
6. A surgical apparatus as recited in claim 1, wherein each of the spaced
apart graduations have associated therewith corresponding numerical
indicia.
7. A surgical apparatus as recited in claim 1, wherein the anvil has first
and second opposed surfaces, the first surface defining a staple forming
area against which staples are driven and second surface having said at
least two spaced apart graduations disposed thereon.
8. In a surgical apparatus configured to apply at least two parallel rows
of staples to body tissue, the apparatus including a staple carrying
cartridge and an anvil mounted adjacent the cartridge and having a staple
forming area against which staples are driven when ejected from the
cartridge, the improvement comprising:
a multiplicity of visible spaced apart graduations provided on each of the
anvil and the staple carrying cartridge to delineate boundaries of the
staple forming area.
9. A surgical apparatus as recited in claim 8 wherein the anvil and the
staple carrying cartridge each define a longitudinal axis in substantially
parallel alignment, the multiplicity of graduations provided on the anvil
define linear markings extending transverse to the longitudinal axis of
the anvil, and the multiplicity of graduations provided on the staple
carrying cartridge define linear markings extending transverse to the
longitudinal axis of the staple carrying cartridge.
10. In a surgical apparatus configured to apply at least two parallel rows
of staples to body tissue, the apparatus including a staple carrying
cartridge and an anvil mounted adjacent the cartridge and having a staple
forming area against which staples are driven when ejected from the
cartridge, the anvil and the staple carrying cartridge each defining a
longitudinal axis in substantially parallel alignment, the improvement
comprising:
a multiplicity of visible spaced apart linear markings provided on and
extending transverse to the longitudinal axis of each of the anvil and the
staple carrying cartridge to delineate boundaries of the staple forming
area, at least two of the linear markings on the longitudinal axis of the
staple carrying cartridge corresponding to the longitudinal positions of
at least two of the linear markings on the longitudinal axis of the anvil.
11. A surgical apparatus as recited in claim 10 wherein the staple carrying
cartridge and the anvil have the same number of linear markings, all the
linear markings on the longitudinal axis of the staple carrying cartridge
corresponding to the longitudinal positions of all the linear markings on
the longitudinal axis of the anvil.
12. In a surgical apparatus configured to apply at least two parallel rows
of staples to body tissue, the apparatus including a staple carrying
cartridge housing a plurality of staples, an anvil mounted adjacent the
cartridge against which the staples are driven when ejected from the
cartridge, the anvil defining a longitudinal axis substantially parallel
to a longitudinal axis defined by the cartridge, and a staple driving
assembly which translates through the cartridge to eject the staples
therefrom, the improvement comprising:
at least two visible spaced apart linear markings provided on, and
extending transverse to the longitudinal axis defined by, each of the
anvil and the cartridge to delineate a range through which the staple
driving assembly translates to eject staples from the cartridge, at least
two of the linear markings on the longitudinal axis of the cartridge
corresponding to the longitudinal positions of at least two of the linear
markings on the longitudinal axis of the anvil.
Description
BACKGROUND
1. Field of the Invention
This invention relates to surgical stapling instruments, and more
particularly, to a graduated anvil for surgical stapling instruments
configured to sequentially apply a plurality of surgical fasteners to body
tissue and optionally incise the fastened tissue.
2. Description of Related Art
Surgical stapling devices wherein tissue is first grasped or clamped
between opposing jaw structure and then joined by means of surgical
fasteners are well known in the art. In some instruments a knife is
provided to cut the tissue which has been joined by the fasteners. The
fasteners are typically in the form of surgical staples or two part
polymeric fasteners.
Instruments for this purpose can comprise two elongated members which are
respectively used to capture or clamp tissue. Typically, one of the
members carries a disposable cartridge which houses a plurality of staples
arranged in at least two lateral rows while the other member comprises an
anvil which defines a surface for forming the staple legs as the fasteners
are driven from the cartridge. Generally, the stapling operation is
effected by a pusher which travels longitudinally through the cartridge
carrying member, with the pusher acting upon the staples to sequentially
eject them from the cartridge. A knife may be associated with the pusher
between the staple rows to longitudinally cut and/or open the tissue
disposed between the rows of staples. Such instruments are disclosed, for
example, in commonly assigned U.S. Pat. Nos. 3,079,606, 3,490,675 and
5,014,899.
A later stapler disclosed in U.S. Pat. No. 3,499,591 to Green applies a
double row of staples on each side of the incision. This is accomplished
by providing a cartridge assembly in which a cam member moves through an
elongate guide path between two sets of staggered staple carrying grooves.
Staple drive members are located within the grooves and are positioned in
such a manner so as to be contacted by the longitudinally moving cam to
effect ejection of the staples.
Each of the instruments described above were designed for use in open
surgical procedures wherein surgeons have direct manual access to the
operative site. However, in endoscopic or laparoscopic procedures, surgery
is performed through a small incision or through narrow cannulae inserted
through small entrance wounds in the skin. In order to address the
specific needs of endoscopic and/or laparoscopic surgical procedures, an
endoscopic surgical stapling apparatus has been developed and is disclosed
in U.S. Pat. No. 5,040,715 to Green et al. This apparatus is well suited
for such procedures and includes a fastener applying assembly having an
anvil and a staple cartridge provided at the distal end of an endoscopic
portion which permits the instrument to be inserted into a cannula and be
remotely operated by the surgeon through manipulation of a proximal handle
mechanism.
During the performance of a surgical stapling procedure, it is necessary
for the surgeon to be well aware of the dimensional limitations of the
instrument which they are using. For example, when tissue is to be stapled
and cut, the surgeon must be able to accurately position the tissue within
the jaws of the apparatus to ensure the tissue will be properly stapled
and cut. In the past, markings have been imprinted on the cartridge
carrying member of such stapling instruments. See, for example, U.S. Pat.
Nos. 4,633,874, Des. 272,851, Des. 278,080 and Des. 284,698. However,
during certain procedures, the instruments may be oriented in a position
where the cartridge carrying member is blocked from the surgeon's view.
Accordingly, there is a need in the art for an anvil having graduations or
markings provided thereon to delineate the dimensions of the instrument
such as the boundaries of the staple forming area formed on the anvil, the
range through which the knife blade travels to cut tissue, and/or the
range through which the staple driving member travels to eject staples
from the cartridge. The present invention describes both conventional and
laparoscopic surgical stapling instruments having graduated anvils to
serve these needs.
SUMMARY
The present invention is directed to an anvil for a surgical stapling
instrument. More particularly, the invention provides a graduated anvil
for a stapling device configured to sequentially apply at least two rows
of staples to body tissue and to optionally cut the tissue between the
rows of staples.
In a preferred embodiment of the invention, the anvil defines first and
second opposed surfaces, with the first surface defining a staple forming
area against which staples are driven. At least two spaced apart
graduations are provided on the second surface of the anvil to delineate
the boundaries of the staple forming area on the first surface of the
anvil.
In another embodiment of the subject invention, at least two spaced apart
graduations are provided on the anvil to delineate a range through which a
knife blade translates to cut tissue. In yet another embodiment of the
subject invention, graduations are provided on the anvil to delineate a
range through which a staple driving assembly translates to eject staples
from the cartridge.
Further features of the subject invention will become more readily apparent
to those having ordinary skill in the art to which this invention pertains
from the following detailed description of the invention taken in
conjunction with the drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
So that one skilled in the art to which the subject invention pertains will
better understand how to make and use the invention, preferred embodiments
of the invention will be described hereinbelow with reference to the
drawings wherein:
FIG. 1 is a perspective view of a surgical stapling instrument configured
for utilization in laparoscopic surgical procedures which includes a
graduated anvil constructed in accordance with a preferred embodiment of
the subject invention;
FIG. 2 is an enlarged perspective view of the fastener applying assembly of
the surgical stapling instrument of FIG. 1, illustrating the graduations
provided on the anvil;
FIG. 3 is an enlarged perspective view in cross-section of the fastener
applying assembly of the surgical instrument shown in FIG. 1, with the
staple driving assembly and knife blade disposed in a pre-fired proximal
position;
FIG. 4 is an enlarged perspective view in cross-section of the fastener
applying assembly of the surgical instrument shown in FIG. 1 with the
stapling driving assembly and knife blade disposed in a post-fired distal
position;
FIG. 5 is a perspective view of a surgical stapling instrument configured
for utilization in open surgical procedures which includes a graduated
anvil constructed in accordance with a preferred embodiment of the subject
invention;
FIG. 6 is an enlarged perspective view of the fastener applying assembly of
the surgical instrument shown in FIG. 5, illustrating the staple forming
surface defined on the anvil.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to the drawings wherein like reference numerals indicate
similar structural features of the subject invention, there is illustrated
in FIGS. 1 and 5 two surgical stapling instruments 100 and 200, which
include a graduated anvil constructed in accordance with preferred
embodiments of the subject invention.
Referring to FIG. 1, surgical stapler 100 is adapted and configured for
utilization during endoscopic or laparoscopic procedures wherein surgery
is performed through a small incision or entrance wound formed in a
patients body. More particularly, during laparoscopic procedures, surgical
stapler 100 can be extended through a trocar or cannula device into the
abdominal cavity of a patient to sequentially apply a plurality of
surgical fasteners to body tissue, and, concomitantly incise the fastened
tissue. Surgical stapler 100 includes a handle assembly 110, an elongate
body 112 which extends distally from handle assembly 110, and a fastener
applying assembly 114 which is operatively associated with a distal end
portion of elongate body 112.
Referring to FIGS. 2-4, fastener applying assembly 114 includes a cartridge
housing 116 configured to support a staple carrying cartridge 118, and an
anvil 120 mounted adjacent cartridge housing 116 which defines a staple
forming surface (not shown) against which surgical fasteners are driven
when they are ejected from cartridge 118. As best seen in FIGS. 3 and 4, a
fastener driving mechanism 122 is operatively associated with staple
cartridge 118 and is configured to translate through cartridge 118, in a
longitudinal direction, to sequentially eject the surgical fasteners
therefrom and drive them against the staple forming surface of anvil 120.
A knife blade 124 is associated with fastener driving mechanism 122 and is
configured to translate through cartridge 118 in conjunction therewith to
form an incision in the body tissue situated between the parallel rows of
staples applied thereto. In operation, the fastener driving mechanism 122
and the knife blade 124 translate together from the pre-fired proximal
position illustrated in FIG. 3 to the post-fired distal position
illustrated in FIG. 4.
As best seen in FIG. 2, the outer surface 126 of anvil 120 is provided with
a series of graduations or markings 130 which correspond to particular
linear dimensions of the anvil 120. More particularly, as illustrated in
FIGS. 3 and 4, graduations 130 serve to delineate the range through which
the fastener driving mechanism 122 travels during a stapling operation.
The graduations provide a user with the capability to determine, from a
remote point of observation (utilizing a laparoscope), the specific
operating range of the staple driving mechanism 122.
The graduations are defined by linear markings coupled with numerical
indicia. Preferably, the graduations are spaced in 10mm intervals and the
numerical indicia decrease in magnitude in a distal direction. An
additional linear marking 132 is preferably provided adjacent to the
distal-most graduation 134 to indicate the distal-most boundary of the
range through which the knife blade 124 travels during a stapling
operations. The linear markings which define the graduations can be
imprinted on the outer surface 126 of anvil 120 utilizing inking, painting
or staining methods common in the art, or, in the alternative, the
markings can be etched into the outer surface 126 of anvil 120.
Referring to FIG. 5, surgical stapler 200 is adapted and configured for
utilization during open surgical procedures wherein surgery is performed
through a radical incision formed in the patients body. This surgical
stapler is also configured to sequentially apply a plurality of surgical
fasteners to body tissue. In general, surgical stapler 200 has a two-part
construction including a cartridge half-section 210 and an anvil
half-section 220. The proximal portion 212 of cartridge half-section 210
and the proximal portion 222 of anvil half-section 220 define a handle
assembly including an actuation mechanism 225. The distal portion 214 of
cartridge half-section 210 and the distal portion 224 of anvil
half-section 220 define a fastener applying assembly.
Referring to FIG. 6, the distal portion 224 of anvil half-section 220
defines a staple forming surface 227 against which surgical fasteners are
driven and formed when ejected from the distal portion 214 of cartridge
half-section 210. Staple forming surface 227 includes a plurality of
staple forming cups 226 disposed in parallel rows and extending
substantially along the length of the distal portion 224 of anvil
half-section 220. The outer surface 228 of distal portion 224 is provided
with a series of graduations or markings 230 which serve to delineate the
linear boundaries of staple forming surfaces 227 and permit visual
observation of these boundaries from a location remote from the surgical
site. Accordingly, a surgeon using surgical stapler 200 will have the
capability to properly orient the apparatus to ensure that the target
tissue is adequately disposed within the boundaries of staple forming
surface 227, thereby reducing the likelihood that the target tissue will
be fastened incompletely. As in the preferred embodiment of FIG. 1,
markings on graduations on the anvil portion preferably correspond to
those provided on the cartridge portion.
Graduations 230 are preferably accompanied by corresponding numerical
indicia and are preferably disposed in 10mm intervals with the indicia
decreasing in magnitude in a distal direction. As in the previous
embodiment, the graduations and the indicia may be imprinted on or etched
into the outer surface 228 of distal portion 224.
Although the graduated anvil of the subject invention has been described
with respect to a preferred embodiment, it is apparent that changes or
modifications may be made thereto without departing from the spirit or
scope of the invention as defined by the appended claims.
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